With the recent increase in obese population, obesity is gaining more attention and the number of obesity clinics is growing, and various social problems arising from obesity are becoming an issue.
Simply speaking, obesity is defined as an over-accumulation of body fat and causes adult diseases such as hypertension, diabetes, and hyperlipidemia, constituting a major part of metabolic syndrome.
Particularly, women tend to desire a slimmer and more balanced body line even when they are not obese.
In order to remove topical fat such as abdominal fat, etc. accumulated from such obesity, a surgical procedure called liposuction is widely used.
However, such surgical procedure may cause severe side effects, such as wounds at the operated sites, edema, paralysis and burning sensation, risk of infection, other injuries to skin or nerves, or perforation of vital organs.
In addition, liposuction requires a substantial amount of recovery time, and there are always serious anesthesia-related risks since surgical procedures like liposuction require local anesthesia or general anesthesia depending on the case.
For the reasons explained above, various lipolysis stimulators which break down topical fat have been used recently to improve external obesity resulting from the accumulation of body fat.
Lipolysis refers to the process in which triglycerides are hydrolyzed into free fatty acids (FFA) and glycerol by the action of hormone sensitive lipase (HSL) accumulated in adipocytes.
The lipolytic agent hyaluronidase, which is the collective name for enzymes catalyzing the degradation of hyaluronic acid, was first known as a dispersion component by Duran-Reynals, but, as it was later observed to exhibit strong activity on hyaluronic acid (HA), it came to be called hyaluronidase (HAase).
Hyaluronidase is known to hydrolyze the linkage between N-acetyl-D-glucosamine and D-glucuronic acid present in hyaluronic acid (HA), chondroitin, and chondroitin sulfates.
Hyaluronidase can accumulate in the dermis and depolymerize long chain mucopolysaccharides causing the retention of associated water and the delay of organic fluid diffusion removing metabolic waste products by microvascular constriction.
Depolymerization of mucopolysaccharides cleaves their long chains into short chains, resulting in the loss of associated water and waste products as well as recovery of venous and lymphatic circulation, thereby achieving the dissipation of localized edema. Utilizing such connective tissue lysing action, hyaluronidase is used in methods of topical fat removal by injecting it subcutaneously to loosen abdominal connective tissue, thereby reducing edema in the tissue and consequently helping blood and lymph circulations so that the degradation and metabolism of abdominal adipose cells are facilitated.
Among the above methods of topical fat removal by lipolysis using hyaluronidase, LLD (Lipolytic Lymph Drainage) treatment is widely used (KR 10-2009-0111916A).
LLD treatment destroys some adipose cells and causes the accumulated fat-related substances to rapidly move to the lymph vessel and be oxidized and excreted, consequently reshaping the overall body line.
However, in the above document, a high dose (1500 IU) hyaluronidase was used, in which case it is difficult to remove fat evenly over a wide area, resulting in dimpling, sagging and wrinkles in the skin. Also, the side effects of the drug make continuous treatment difficult.
In addition, KR 10-2013-0003394A discloses an injection composition preventing pain and allergy by mixing 1 cc each of hyaluronidase, lidocaine which is a local anesthetics, and pheniramine which is an antihistamine. However, this composition also uses hyaluronidase at a high dose, and injection of the composition is performed on 4 to 6 points with a 5-cm interval between the injection points, and thus still has the problem of not being able to avoid the side effects such as dimpling or sagging and wrinkling.